Q: I

Have an 11-year-old niece who suffers from food and...

May 18, 2000|By Dr. Allen Douma.

Q: I have an 11-year-old niece who suffers from food and other allergies (dust, outdoor pollens, etc.). She gets shots about every other week for treatment. Every time she exhibits bad behavior or is moody, her mother insists that her allergies are acting up again. Do allergies make a child misbehave?

A: Allergic disorders are among the most common primary-care problems in medicine, affecting as many as one-quarter of the population in developed countries.

Allergic rhinitis is the most common allergic disorder and, from what you've said, is probably the one giving your niece problems.

The prevalence of allergic rhinitis increases during childhood and is highest just after adolescence.

The symptoms include nasal obstruction, itching and secretions, which can cause poor appetite, fatigue and sore throat.

The allergic reaction can also affect the sinuses and middle ear.

Allergic rhinitis can be continuous (perennial), seasonal or episodic.

Perennial allergic rhinitis occurs all the time but tends to be worse in the winter. I hope your niece's mother is working hard at eliminating allergens, in addition to having her take allergy shots.

Among school-age children and adolescents, these disorders result in substantial illness and school absenteeism; they have an adverse impact on school performance and quality of life, and may cause emotional stress.

As you know from experience, the symptoms of moderate to severe upper respiratory distress can make any of us cranky.

Younger children who can't understand their illness and symptoms can become frightened and angry, and such emotions can be reflected in their behavior.

Having said all that, I certainly understand the implied concern in your letter. As more and more behaviors are termed illnesses and diseases, more and more people (both children and adults) are using the disease designation to explain away plain old misbehavior.

When a doctor sees a biochemical change or a physiologic malfunction, it is relatively easy to assign the term "abnormal" to that condition. But disorders in behavior and temperament are not so easy to classify.

Many behavioral "disorders" are no more than normal variations reflective of individual biologic and environmental traits.

Even some annoying (at home) and embarrassing (in public) immature and "childish" behaviors are relatively normal as children strive to control their environment and perform at their developmental level.

Also, some children tolerate frustration well, are able to persevere at tasks and cope with difficulties easily. Others have more of a problem, and any opportunity to "justify" immature behaviors is seized upon, especially if they just don't feel well. There are no medical "cures" for these misbehaviors and the answer is in behavior management.

Parents, teachers, family friends and other caregivers must try to be empathetic toward the child with such a chronic disorder, but also must encourage the child to rise above the problem, do well in school and behave appropriately.